Digital Media use on Interactions Between Mother and Child: Differences in Infants’ Early Years

Uso da Mídia Digital nas Interações entre Mãe e Filho: Diferenças nos Primeiros Anos de Vida dos Bebês

Uso de Medios Digitales en Interacciones entre Madre e Hijo: Diferencias en los Primeros Años de los Bebés

Elisa Cardoso Azevedo Helena da Silveira Riter Maria Adélia Minghelli Pieta Giana Bitencourt Frizzo About the authors

Abstract

Children are increasingly using digital media (smartphones, tablets, and television) at an early age, which is affecting their development. This study aims to describethe ways in which media isused by mothers and infants, and to examine similarities and differences between infants aged 0-3 years. 435 mothers of infants aged 0-36 months responded to an online survey. A sociodemographic questionnaire and media use questionnairewere used. The results show that mothers routinely use media to entertain infants, specially when they feel the need to rest or do household chores.We identified that media use differs and increases with the infants’ age. The study addresses a current and culturally relevant phenomenon; it expands the understanding of media use, discusses their impact, addresses repercussions on child development, daily life, and family interaction, and offers recommendations on their use.

Keywords:
childhood; family; technology

Resumo

As crianças estão usando mídias digitais (smartphones, tablets e televisão) precocemente, de maneira crescente e com influência no desenvolvimento. Este estudo objetivou descrever o uso de mídias por mães e bebês, e examinar semelhanças e diferenças entre bebês de 0-3 anos. 435 mães de bebês de 0-36 meses responderam a um survey online. Foram utilizados: questionário sociodemográfico e questionário de uso de mídia. Os resultados mostram que as mães usam mídias na rotina, para entreter os bebês, e sentem mais necessidade de permitir que seus filhos usem mídias quando precisam descansar ou fazer tarefas domésticas. Identifica-se que o uso de mídias difere e aumenta conforme a idade dos bebês.O estudo aborda um fenômeno atual e culturalmente relevante. Amplia a compreensão do uso de mídias, discute o impacto destas, aborda repercussões no desenvolvimento infantil, no cotidiano e na interação familiar e oferece recomendações sobre o seu uso.

Palavras-chave:
infância; família; tecnologia

Resumen

Los niños están utilizando, de manera temprana y creciente, los medios digitales (teléfonos inteligentes, tabletas y televisión), lo que impacta en su desarrollo. Este estudio tuvo como objetivo describir el uso de los medios por madres y bebés, así como examinar lassimilitudes y diferencias entre bebés de 0 a 3 añosde edad. Una encuesta en línea fue respondida por 435 madres de bebés de entre 0 y 36 meses. Se utilizaron elcuestionario sociodemográfico y elcuestionario de uso de medios. Los resultados muestran que las madres usan los medios de comunicación para entretener a sus bebés y también les permiten usar los medios de comunicación cuando necesitan descansar o hacer las tareas del hogar. Se identifica que el uso de los medios de comunicación difiere y aumenta con la edad de los bebés. Este estudio aborda un fenómeno actual y culturalmente relevante. Amplía la comprensión del uso de los medios digitales, analiza su impacto, aborda las repercusiones en el desarrollo infantil, la vida diaria y la interacción familiar, además de ofrecer recomendaciones sobre su uso.

Palabras clave:
infancia; familia; tecnologia

In recent years there was a significant increase in digital media use by children, who have been introduced to them at progressively younger ages (Rideout & Robb, 2020Rideout, V., & Robb, M. B. (2020). The Common Sense census: Media use by kids age zero to eight, 2020. Retrieved from https://www.commonsensemedia.org/sites/default/files/uploads/research/2020_zero_to_eight_census_final_web.pdf
https://www.commonsensemedia.org/sites/d...
). Infants have become increasingly adept at using digital media, with the present generation of digital natives being the first to be immersed in technology from birth (Kildare & Middlemiss, 2017Kildare, C. A., & Middlemiss, W. (2017). Impact of parents mobile device use on parent-child interaction: A literature review. Computers in Human Behavior, 75, 579-593. doi:10.1016/j.chb.2017.06.003
https://doi.org/10.1016/j.chb.2017.06.00...
; Nevski & Siibak, 2016Nevski, E., & Siibak, A. (2016). The role of parents and parental mediation on 0-3-year olds’ digital play with smart devices: Estonian parents’ attitudes and practices. Early Years: International Research Journal, 36(3), 227-241. doi:10.1080/09575146.2016.1161601
https://doi.org/10.1080/09575146.2016.11...
; Radesky & Christakis, 2016Radesky, J. S., Peacock-Chambers, E., Zuckerman, B., & Silverstein, M. (2016). Use of mobile technology to calm upset children. JAMA Pediatrics, 170(4), 397-399. doi:10.1001/jamapediatrics.2015.4260
https://doi.org/10.1001/jamapediatrics.2...
).

Digital media useis starting at a crucial developmental stage, in which infantsestablish the habits and relationships which will serve as a basis for future experiences (Mallmann & Frizzo, 2019Mallmann, M. Y., & Frizzo, G. B. (2019). O uso das novas tecnologias em famílias com bebês: Um mal necessário? [The use of new technologies in families with babies: A necessaryevil?]. Revista Cocar,(7), 26-46. doi:10.31792/rc.v0i7
https://doi.org/10.31792/rc.v0i7...
). In their early years, children need to undergo a variety of sensorial experiences (Piaget, 1936/1978Piaget, J. (1978). O nascimento da inteligência na criança [The origins of intelligence in children](A. Cabral, Trans., 3rd ed.). Rio de Janeiro, RJ: Zahar. (Original work published 1936).) and the quality of the first relationships between infants and caregivers will build subsequent emotional development (Winnicott, 1986/2005Winnicott, D. W. (2005). Tudo começa em casa [Home iswherewe start from](P. C. Sandler, Trans., 4th ed.). São Paulo, SP: Martins Fontes. (Original work published in 1986).). It is crucial to understand the potential influence of digital media on child development and onparent-child interactions since positive experiences are the basis for a good brain (Shonkoff, 2017Shonkoff, J. P. (2017). Breakthrough impacts: What science tells us about supporting early childhood development. YC Young Children,72(2), 8-16. Retrieved from https://www.jstor.org/stable/90004117
https://www.jstor.org/stable/90004117...
) and for cognitive (Piaget, 1936/1978Piaget, J. (1978). O nascimento da inteligência na criança [The origins of intelligence in children](A. Cabral, Trans., 3rd ed.). Rio de Janeiro, RJ: Zahar. (Original work published 1936).) and emotional development (Winnicott, 1986/2005Winnicott, D. W. (2005). Tudo começa em casa [Home iswherewe start from](P. C. Sandler, Trans., 4th ed.). São Paulo, SP: Martins Fontes. (Original work published in 1986).).

Pediatric organizations across the world have expressed concerns about the use of digital media in childhood. Current recommendations discourage the use of these technologies before 2 years of age (American Academy of Pediatrics [AAP] Council on Communications and Media [CCM], 2016American Academy of Pediatrics, & Council on Communications and Media. (2016). Media and young minds. Pediatrics, 138(5), e20162591. doi:10.1542/peds.2016-2591
https://doi.org/10.1542/peds.2016-2591...
). Despite these recommendations, Kabali et al. (2015Kabali, H. K., Irigoyen, M. M., Nunez-Davis, R., Budacki, J. G., Mohanty, S. H., Leister, K. P., & Bonner, R. L. (2015). Exposure and use of mobile media devices by young children. Pediatrics,136(6), 1044-50. doi:10.1542/peds.2015-2151
https://doi.org/10.1542/peds.2015-2151...
) found that 92.2% of infants are first introduced to digital media before the age of one. Studies suggest that the pediatrics’ orientations are not followed by families around the world (Duch et al., 2013Duch, H., Fisher, E. M., Ensari, I., Font, M., Harrington, A., Taromino, C., … Rodriguez, C. (2013). Association of screen time use and language development in Hispanic toddlers: A cross-sectional and longitudinal study. Clinical Pediatrics, 52(9), 857-865. doi:10.1177/0009922813492881
https://doi.org/10.1177/0009922813492881...
; Kabali et al., 2015Kabali, H. K., Irigoyen, M. M., Nunez-Davis, R., Budacki, J. G., Mohanty, S. H., Leister, K. P., & Bonner, R. L. (2015). Exposure and use of mobile media devices by young children. Pediatrics,136(6), 1044-50. doi:10.1542/peds.2015-2151
https://doi.org/10.1542/peds.2015-2151...
; Mallmann & Frizzo, 2019Mallmann, M. Y., & Frizzo, G. B. (2019). O uso das novas tecnologias em famílias com bebês: Um mal necessário? [The use of new technologies in families with babies: A necessaryevil?]. Revista Cocar,(7), 26-46. doi:10.31792/rc.v0i7
https://doi.org/10.31792/rc.v0i7...
). There are changes in media use over time, as new devices and contents are made increasingly available. In 2011, for instance, fewer than 1% of children had their own tablets, in 2013 this number grew to 7%, and had an increase of 42% in 2017 (Common Sense Media, 2017Common Sense Media. (2017). The Common Sense Census: Media use by kids age zero to eight. A special population: children under two. Retrieved from https://www.commonsense.org/zero-to-eight-census
https://www.commonsense.org/zero-to-eigh...
); by 2020, nearly half (46%) of 2- to 4-year-olds have their own mobile device (Rideout & Robb, 2020Rideout, V., & Robb, M. B. (2020). The Common Sense census: Media use by kids age zero to eight, 2020. Retrieved from https://www.commonsensemedia.org/sites/default/files/uploads/research/2020_zero_to_eight_census_final_web.pdf
https://www.commonsensemedia.org/sites/d...
).

Recent orientations are less pres criptive and encourage families to reflect on their use of digital media (Sociedade Brasileira de Pediatria[SBP], 2019Sociedade Brasileira de Pediatria. (2019). #Menostela #maissaúde: Manual de orientação [#Less screen #more health: Guidance manual]. Retrieved from https://www.sbp.com.br/imprensa/detalhe/nid/menos-telas-mais-saude/
https://www.sbp.com.br/imprensa/detalhe/...
; Royal College of Paediatrics and Child Health [RCPCH], 2019Royal College of Paediatrics and Child Health. (2019). The health impacts of screen time: A guide for clinicians and parents. Retrieved from https://www.rcpch.ac.uk/resources/health-impacts-screen-time-guide-clinicians-parents
https://www.rcpch.ac.uk/resources/health...
). They also emphasize the importance of preserving routine activities such as mealtime and bedtime (World Health Organization [WHO], 2019World Health Organization. (‎2019). Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. Geneva, Switzerland: Author.Retrieved from http://www.who.int/iris/handle/10665/311664
http://www.who.int/iris/handle/10665/311...
), which constitute crucial opportunities for parent-child interaction and should therefore be carried out without the use of screens. These findings suggest that, on its own, the duration of media use - the most frequently investigated variable in studies of the subject - may not be able to capture the complexity of the media usage patterns shown by infants and their families. Thus, it is relevant to investigate more aspects of the use of digital media, such as moments when the child uses it, parents’ reasons for offering digital media, and parental mediation, for example.

Among the variables that seem to interfere with digital media use, age has been widely reported in studies (Arufe-Giráldez, Sanmiguel-Rodríguez, Zagalaz-Sánchez, Cachón-Zagalaz, & González-Valero, 2020Arufe-Giráldez, V. I., Sanmiguel-Rodríguez, A., Zagalaz-Sánchez, M. L., Cachón-Zagalaz, J., & González-Valero, G. (2020). Sleep, physical activity and screens in 0-4 years Spanish children during the COVID-19 pandemic: Were the WHO recommendations met? Journal of Human Sport and Exercise, 17(3), 1-20. doi:10.14198/jhse.2022.173.02
https://doi.org/10.14198/jhse.2022.173.0...
; Cartanyà-Hueso et al., 2021Cartanyà-Hueso, A., Lidón-Moyano, C., Cassanello, P., Díez-Izquierdo, A., Martín-Sánchez, J. C., Balaguer, A., & Martínez-Sánchez, J. M. (2021). Smartphone and tablet usage during COVID-19 pandemic confinement in children under 48 months in Barcelona (Spain). Healthcare (Basel, Switzerland), 9(1), 96. doi:10.3390/healthcare9010096
https://doi.org/10.3390/healthcare901009...
; Kabali et al., 2015Kabali, H. K., Irigoyen, M. M., Nunez-Davis, R., Budacki, J. G., Mohanty, S. H., Leister, K. P., & Bonner, R. L. (2015). Exposure and use of mobile media devices by young children. Pediatrics,136(6), 1044-50. doi:10.1542/peds.2015-2151
https://doi.org/10.1542/peds.2015-2151...
; Nevski & Siibak, 2016Nevski, E., & Siibak, A. (2016). The role of parents and parental mediation on 0-3-year olds’ digital play with smart devices: Estonian parents’ attitudes and practices. Early Years: International Research Journal, 36(3), 227-241. doi:10.1080/09575146.2016.1161601
https://doi.org/10.1080/09575146.2016.11...
; Rideout & Robb, 2020Rideout, V., & Robb, M. B. (2020). The Common Sense census: Media use by kids age zero to eight, 2020. Retrieved from https://www.commonsensemedia.org/sites/default/files/uploads/research/2020_zero_to_eight_census_final_web.pdf
https://www.commonsensemedia.org/sites/d...
), showing that screen time increases with age. The kind of media used also differs according to thechild’s age (Rideout & Robb, 2020Rideout, V., & Robb, M. B. (2020). The Common Sense census: Media use by kids age zero to eight, 2020. Retrieved from https://www.commonsensemedia.org/sites/default/files/uploads/research/2020_zero_to_eight_census_final_web.pdf
https://www.commonsensemedia.org/sites/d...
).

Kabali et al. (2015Kabali, H. K., Irigoyen, M. M., Nunez-Davis, R., Budacki, J. G., Mohanty, S. H., Leister, K. P., & Bonner, R. L. (2015). Exposure and use of mobile media devices by young children. Pediatrics,136(6), 1044-50. doi:10.1542/peds.2015-2151
https://doi.org/10.1542/peds.2015-2151...
) also showed differences in the context of digital media use within the infant’s first 4 years. According to them, the first use occurs mostly before their first year and digital media use becomes broader and more frequent, as well as with less parental mediation over time. Owning mobile devices is also more common among older children.

These differences can be related to the skills that children acquire over time, which generates more opportunities for engagement with the devices (Aguilar-Farias et al., 2020Aguilar-Farias, N., Toledo-Vargas, M., Miranda-Marquez, S., Cortinez-O’Ryan, A., Cristi-Montero, C., Rodriguez-Rodriguez, F., ... Del Pozo Cruz, B. (2020). Sociodemographic predictors of changes in physical activity, screen time, and sleep among toddlers and preschoolers in Chile during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 18(1), 176. doi:10.3390/ijerph18010176
https://doi.org/10.3390/ijerph18010176...
), as well as the fact that infants rely on their parents to access digital media since they cannot independently engage in leisure activities, unlike older children (Kildare & Middlemiss, 2017Kildare, C. A., & Middlemiss, W. (2017). Impact of parents mobile device use on parent-child interaction: A literature review. Computers in Human Behavior, 75, 579-593. doi:10.1016/j.chb.2017.06.003
https://doi.org/10.1016/j.chb.2017.06.00...
). Digital media use in infancy is necessarily contingent on the offer of these resources by parents.Thus, it is relevant to investigate similarities and differences in use according to age group from a developmental perspective to advance understanding of this phenomenon in early childhood.

Studies on the frequency of use have raised concerns about the potential effect digital media use can haveon the interaction between parents and children. The use of digital media is associated with reduced and altered family interactions, lower parental sensitivity and responsiveness, reduced nonverbal communication, and reduced attention to children (Kabali et al., 2015Kabali, H. K., Irigoyen, M. M., Nunez-Davis, R., Budacki, J. G., Mohanty, S. H., Leister, K. P., & Bonner, R. L. (2015). Exposure and use of mobile media devices by young children. Pediatrics,136(6), 1044-50. doi:10.1542/peds.2015-2151
https://doi.org/10.1542/peds.2015-2151...
; Kildare & Middlemiss, 2017Kildare, C. A., & Middlemiss, W. (2017). Impact of parents mobile device use on parent-child interaction: A literature review. Computers in Human Behavior, 75, 579-593. doi:10.1016/j.chb.2017.06.003
https://doi.org/10.1016/j.chb.2017.06.00...
; McDaniel & Radesky, 2017McDaniel, B. T., & Radesky, J. S. (2017). Technoference: Parent distraction with technology and associations with child behavior problems.Child Development,89(1), 100-109. doi:10.1111/cdev.12822
https://doi.org/10.1111/cdev.12822...
; Radesky et al., 2015Radesky, J. S., Miller, A. L., Rosenblum, K. L., Appugliese, D., Kaciroti, N., & Lumeng, J. C. (2015). Maternal mobile device use during a structured parent-child interaction task. Academic Pediatrics, 15(2), 238-244. doi:10.1016/j.acap.2014.10.001
https://doi.org/10.1016/j.acap.2014.10.0...
; Radesky, et al., 2016Radesky, J. S., Peacock-Chambers, E., Zuckerman, B., & Silverstein, M. (2016). Use of mobile technology to calm upset children. JAMA Pediatrics, 170(4), 397-399. doi:10.1001/jamapediatrics.2015.4260
https://doi.org/10.1001/jamapediatrics.2...
), all of which are indicative of low-quality interactions (Munzer, Miller, Weeks, Kaciroti, & Radesky, 2019Munzer, T.G., Miller, A.L., Weeks, H.M., Kaciroti, N., & Radesky, J. (2019). Parent-toddler social reciprocity during reading from electronic tablets vs print books. JAMAPediatrics,173(11), 1076-1083. doi:10.1001/jamapediatrics.2019.3480
https://doi.org/10.1001/jamapediatrics.2...
). The constant and increasing use of digital media among infants is associated with delays in emotional (Napier, 2014Napier, C. (2014). How use of screen media affects the emotional development of infants. Primary Health Care, 24(2), 18-25. doi:10.7748/phc2014.02.24.2.18.e816
https://doi.org/10.7748/phc2014.02.24.2....
; Raman et al., 2017Raman, S., Guerrero-Duby, S., McCullough, J. L., Brown, M., Ostrowski-Delahanty, S., Langkamp, D., & Duby, J. C. (2017). Screen exposure during daily routinesand a young child’s risk for having social-emotional delay. ClinicalPediatrics, 56(13), 1244-1253. doi:10.1177/0009922816684600
https://doi.org/10.1177/0009922816684600...
), cognitive (Radesky & Christakis, 2016Radesky, J. S., & Christakis, D. A. (2016). Increased screen time: Implications for early childhood development and behavior. Pediatric Clinics, 63(5), 827-839. doi:10.1016/j.pcl.2016.06.006
https://doi.org/10.1016/j.pcl.2016.06.00...
), and language development (Duch et al., 2013Duch, H., Fisher, E. M., Ensari, I., Font, M., Harrington, A., Taromino, C., … Rodriguez, C. (2013). Association of screen time use and language development in Hispanic toddlers: A cross-sectional and longitudinal study. Clinical Pediatrics, 52(9), 857-865. doi:10.1177/0009922813492881
https://doi.org/10.1177/0009922813492881...
). No studies to date have revealed any benefits of digital media use at this age (Schmidt, Rich, Rifas-Shiman, Oken, & Taveras, 2009Schmidt, M., Rich, M., Rifas-Shiman, S.L., Oken, E., & Taveras, E. M. (2009). Television viewing in infancy and child cognition at 3 years of age in a US cohort. Pediatrics,123(3), e370-e375.doi:10.1542/peds.2008-3221
https://doi.org/10.1542/peds.2008-3221...
; Strasburger, 2007Strasburger, V. (2007). First do no harm: Why have parents and pediatricians missed the boat on children and media? Journal of Pediatrics, 151(4), 334-336. doi:10.1016/j.jpeds.2007.05.040
https://doi.org/10.1016/j.jpeds.2007.05....
; Radesky & Christakis, 2016Radesky, J. S., & Christakis, D. A. (2016). Increased screen time: Implications for early childhood development and behavior. Pediatric Clinics, 63(5), 827-839. doi:10.1016/j.pcl.2016.06.006
https://doi.org/10.1016/j.pcl.2016.06.00...
; RCPCH, 2019).

There is an overall need for studies that examine the influence of digital media on families with infants since this is a historically recent phenomenon. It is crucial to understand when and how infants use digital media, which types of technology are most commonly used,and the situations and reasons for using these devices. Considering this growing phenomenon and the current gaps in the scientific literature, this study describes the use of digital media by mothers and infants and verifies whether there are differences inthese behaviors between three age groups: 0-12, 13-24, and 25-36 months.

Method

Participants

This study was composed of 435 Brazilian mothers of infants aged 0-36 months.Mothers of children with genetic syndromes, congenital malformations, heart problems, neurological issues, or developmental delays diagnosed by a physician or other health professionals were excluded from the study. These criteria were examined using screening questions administered before the online questionnaire.

This exploratory, descriptive, cross-sectional quantitative study was conducted as part of a larger project “Infants, families and technology use: a multi-methods study of child development” (Frizzo et al., 2017).

Instruments

Sociodemographic questionnaire: This instrument was used to investigate the sociodemographic characteristics of participants and their families, including their age, education level, living conditions, and income (Núcleo de Pesquisa e Intervenção em Famílias com Bebês e Crianças[NUFABE], 2017Núcleo de Pesquisa e Intervenção em Famílias com Bebês e Crianças. (2017). Questionário de dados sócio-demográficos [Socio-demographic data questionnaire].Porto Alegre, RS: Universidade Federal do Rio Grande do Sul. Instrumento não publicado.).

Media use questionnaire: The “Zero to Eight: Children’s Media Use in America 2013” (Common Sense Media, 2013Common Sense Media. (2013). Zero to Eight: Children’s media use in America 2013. Retrieved from https://www.commonsensemedia.org/file/zero-to-eight-2013pdf-0/download
https://www.commonsensemedia.org/file/ze...
) questionnaire was adapted to Brazilian Portuguese with the permission of the original researchers. The instrument collects demographic information about the respondents. It contains detailed questions about the types of media present in their homes, the devices used by infants and their parents, as well as the type and duration of this usage. Questions such as the following were also added to the instrument: “In what situations do you feel the greatest need to offer mobile devices (smartphone, tablet computer, or portable DVD player) to your child?”, “Do you usually offer mobile devices (smartphone, tablet, or portable DVD player) to your child during any of the following routine activities?”.

Procedures

Data collection. Participants were sampled by convenience. The study was advertised on social networks using the following invitation: “We would like to learn about tablet, computer, and cell phone usage by mothers of infants aged 36 months or younger.” This prompt was accompanied by a link to an informed consent document and the online survey. Data were collected from October 2018 to April 2019.

Data analysis. Descriptive and frequency analyses were used to examine the sociodemographic characteristics of mothers and infants, as well as their digital media use (Robson, 2002Robson, C. (2002). Real-world research: A resource for social scientists and practitioner-researchers (2nd ed.). Malden, MA: Blackwell.). Bivariate analyses (X²) were conducted to investigate differences in media use (routine use, reasons for use, method of use, infant’s reaction when media use is not allowed, infant’s reaction to mother’s use of digital media, and interference in family life) between age categories (0-12 months; 13-24 months; 24-36 months). Analyses were conducted using the Statistical Package for the Social Sciences (SPSS), version 24.

Ethical Considerations

The project was approved by the Research Ethics Committee of the Instituto de Psicologia da Universidade Federal do Rio Grande do Sul (CAAE. No. 69947117.6.0000.5334).

Results

The survey was completed by mothers (median age of 33.37 year; standard deviation of 4.79) from all states in the country, though most participants were from Southern Brazil (84.1%)(Table 1). Most infants were born at full term (85,5%). Most mothers were white (88%) with high education levels (32.4% completed undergraduate degrees and 44.4% completed graduate degrees) from upper-middle-class families. Mean monthly family income was calculated based on the minimum wage, which at the time of data collection, was R$ 954,00. Most mothers (57.5%) reported that the income was used to support three people. The majority of participants were in a relationship with their child’s father (96%). Most individuals (81%) were married.

Table 1
Sociodemographic characteristics of mothers and infants (N = 435)

Digital devices ownership and use

Internet access was highly prevalentand different forms of digital media were present in the homes of most participants (Table 2). Smartphones were owned by nearly every participant and most families owned laptops. Some infants had their own mobile devices and also TV in the bedroom. Ownership of a digital device was more prevalent according to infant age. A total of 54.5% of infants used computers or mobile devices (smartphones or tablets).

Table 2
Items owned by the family and infant

Televisions were present in a large number of homes, as 43% of mothers reported that the TV was frequently on, even if no one was watching it. Also, most families (61.6%) alternated between TV programs directed at adults and children over the day.

Downloaded apps

Some mothers (33.6%) downloaded apps for their children on their own smartphones, with 61.6% of these citing YouTube and Netflix. A few mothers (32.9%) also reported that they had downloaded apps designed to teach their children.

Contexts and behaviors related to digital media use

Bivariate analyses revealed differences in the use of mobile devices during daily routine, reasons for giving children access to mobile devices, method of use, infant’s reaction when media use is not allowed, infant’s reaction to mother’s use of digital media, and interference in family life between age categories (Figure 1 and Figure 2).

Figure 1
Routine use of digital media and reasons for use.

Figure 2
Interference and reactions to the use of digital media.

Routine use of digital media and reasons for use

Children’s use of digital devices during meals increased in frequency with age. Mothers cited that they allowed their children to use mobile devices in restaurants and few of them reported giving mobile devices to their children at bedtime.

Participants reported using digital media to calm their children, especially those aged 13-24 months, and to keep them from disturbing those around them. Mothers also reported that sometimes they felt the need to give their children digital devices so they could carry out their own activities such ashousework, work from home, or rest. This was particularly true for older children. Mothers also allowed children to use digital media on other occasions, such as parties, when receiving guests, and during short or long trips. Some mothers, especially those whose children were less than one year old, reported feeling the greatest need to rely on digital media during playtime.

Method of use

Most infants used digital media during interactions with adults. Some mothers reported that their children used digital media on their own, although this was less frequent than the other types of usage observed. The frequency of independent media usage increased with age.

Infant’s reaction when media use is not allowed

Most mothers observed a negative reaction in their children when access to mobile devices was denied;respondents noted, however, that,immediately after this happened,their children quickly turned to other toys or activities, especially those over 13 months.

Infant’s reaction to mother’s use of digital media and interference in family life

Many mothers noted that when using their own mobile devices, children often reacted by trying to get their mother’s attention, asking to use the device with her. This behavior was observed across all age groups in this study.

Discussion

This study describes the use of digital media by mothers and infants and examines the differences in behavior between age groups 0-12, 13-24, and 25-36 months. The data provided a comprehensive picture of mothers’ and infants’ media use patterns and offers evidence-based recommendations on the use of digital media by families and infants.

Results confirmed the widespread presence of digital media in the participants’ homes and infants’ daily routines, similarly to what was found in previous studies (Common Sense Media, 2017Common Sense Media. (2017). The Common Sense Census: Media use by kids age zero to eight. A special population: children under two. Retrieved from https://www.commonsense.org/zero-to-eight-census
https://www.commonsense.org/zero-to-eigh...
; Rideout & Robb, 2020Rideout, V., & Robb, M. B. (2020). The Common Sense census: Media use by kids age zero to eight, 2020. Retrieved from https://www.commonsensemedia.org/sites/default/files/uploads/research/2020_zero_to_eight_census_final_web.pdf
https://www.commonsensemedia.org/sites/d...
). The use of digital media differed in the age group of zero to 3 years, with increased use in older infants, as in the study by Kabali et al. (2015Kabali, H. K., Irigoyen, M. M., Nunez-Davis, R., Budacki, J. G., Mohanty, S. H., Leister, K. P., & Bonner, R. L. (2015). Exposure and use of mobile media devices by young children. Pediatrics,136(6), 1044-50. doi:10.1542/peds.2015-2151
https://doi.org/10.1542/peds.2015-2151...
). More than half of infants in our sample used computers or mobile devices (smartphones or tablets), similarly to other studies, in which a high frequency of digital media use among infants was noted (Kabali et al., 2015Kabali, H. K., Irigoyen, M. M., Nunez-Davis, R., Budacki, J. G., Mohanty, S. H., Leister, K. P., & Bonner, R. L. (2015). Exposure and use of mobile media devices by young children. Pediatrics,136(6), 1044-50. doi:10.1542/peds.2015-2151
https://doi.org/10.1542/peds.2015-2151...
; Nevski & Siibak, 2016Nevski, E., & Siibak, A. (2016). The role of parents and parental mediation on 0-3-year olds’ digital play with smart devices: Estonian parents’ attitudes and practices. Early Years: International Research Journal, 36(3), 227-241. doi:10.1080/09575146.2016.1161601
https://doi.org/10.1080/09575146.2016.11...
; Rideout & Robb, 2020Rideout, V., & Robb, M. B. (2020). The Common Sense census: Media use by kids age zero to eight, 2020. Retrieved from https://www.commonsensemedia.org/sites/default/files/uploads/research/2020_zero_to_eight_census_final_web.pdf
https://www.commonsensemedia.org/sites/d...
), despite recommendations against the use of these technologies by children aged two years or younger (AAP & CCM, 2016; SBP, 2019). Within our sample, laptops were largely present at home,while tablets tend to be more popular in North America (Common Sense Media, 2017Common Sense Media. (2017). The Common Sense Census: Media use by kids age zero to eight. A special population: children under two. Retrieved from https://www.commonsense.org/zero-to-eight-census
https://www.commonsense.org/zero-to-eigh...
).

In our investigation, televisions are present in a great number of homes and are frequently on; the same was observed in the Common Sense Media (2017Common Sense Media. (2017). The Common Sense Census: Media use by kids age zero to eight. A special population: children under two. Retrieved from https://www.commonsense.org/zero-to-eight-census
https://www.commonsense.org/zero-to-eigh...
) study, in which many families with infants under two (42%) reported leaving their TV on in the background most of the time. This may be a problematic distraction, potentially interfering with parent-child interactions and leading to issues such as a marked decrease in maternal responsiveness (Napier, 2014Napier, C. (2014). How use of screen media affects the emotional development of infants. Primary Health Care, 24(2), 18-25. doi:10.7748/phc2014.02.24.2.18.e816
https://doi.org/10.7748/phc2014.02.24.2....
; Schmidt et al., 2009Schmidt, M., Rich, M., Rifas-Shiman, S.L., Oken, E., & Taveras, E. M. (2009). Television viewing in infancy and child cognition at 3 years of age in a US cohort. Pediatrics,123(3), e370-e375.doi:10.1542/peds.2008-3221
https://doi.org/10.1542/peds.2008-3221...
), which can be a developmental risk factor for young children (Schmidt et al., 2009Schmidt, M., Rich, M., Rifas-Shiman, S.L., Oken, E., & Taveras, E. M. (2009). Television viewing in infancy and child cognition at 3 years of age in a US cohort. Pediatrics,123(3), e370-e375.doi:10.1542/peds.2008-3221
https://doi.org/10.1542/peds.2008-3221...
). In Rideout and Robb’s (2020Rideout, V., & Robb, M. B. (2020). The Common Sense census: Media use by kids age zero to eight, 2020. Retrieved from https://www.commonsensemedia.org/sites/default/files/uploads/research/2020_zero_to_eight_census_final_web.pdf
https://www.commonsensemedia.org/sites/d...
) study, most families alternate between TV programs directed at adults and children over the day.

The most downloaded app by mothers in this sample was YouTube, which seems to be the most popular app among infants aged 1 to 2 years, according also to Kabali et al. (2015Kabali, H. K., Irigoyen, M. M., Nunez-Davis, R., Budacki, J. G., Mohanty, S. H., Leister, K. P., & Bonner, R. L. (2015). Exposure and use of mobile media devices by young children. Pediatrics,136(6), 1044-50. doi:10.1542/peds.2015-2151
https://doi.org/10.1542/peds.2015-2151...
) study. Rideout and Robb (2020Rideout, V., & Robb, M. B. (2020). The Common Sense census: Media use by kids age zero to eight, 2020. Retrieved from https://www.commonsensemedia.org/sites/default/files/uploads/research/2020_zero_to_eight_census_final_web.pdf
https://www.commonsensemedia.org/sites/d...
) observed that 39% of children between two and four years of agewatch online videos on sites such as YouTube. The service has a simple, accessible interface so that even young children can use it. However, as noted by Elias and Sulkin (2017Elias, N., & Sulkin, I. (2017). YouTube viewers in diapers: An exploration of factors associated with amount of toddlers’ online viewing. Cyberpsychology: Journal of Psychosocial Research on Cyberspace, 11(3), 1-18. doi:10.5817/CP2017-3-2
https://doi.org/10.5817/CP2017-3-2...
), children’s underdeveloped technical, critical, and social skills make them especially vulnerable to commercial and/or age-inappropriate content, so that their use of this media should be mediated by an adult. As discussed in previous studies, parents often download apps for their children at an early age to not fall behind their peers (Radesky et al., 2016Radesky, J. S., Peacock-Chambers, E., Zuckerman, B., & Silverstein, M. (2016). Use of mobile technology to calm upset children. JAMA Pediatrics, 170(4), 397-399. doi:10.1001/jamapediatrics.2015.4260
https://doi.org/10.1001/jamapediatrics.2...
) due to a belief in digital media’s educational value, which is reinforced by marketing strategies (Nevski & Siibak, 2016Nevski, E., & Siibak, A. (2016). The role of parents and parental mediation on 0-3-year olds’ digital play with smart devices: Estonian parents’ attitudes and practices. Early Years: International Research Journal, 36(3), 227-241. doi:10.1080/09575146.2016.1161601
https://doi.org/10.1080/09575146.2016.11...
; Rideout & Robb, 2020Rideout, V., & Robb, M. B. (2020). The Common Sense census: Media use by kids age zero to eight, 2020. Retrieved from https://www.commonsensemedia.org/sites/default/files/uploads/research/2020_zero_to_eight_census_final_web.pdf
https://www.commonsensemedia.org/sites/d...
). However, no studies have identified any benefits (Radesky & Christakis, 2016Radesky, J. S., & Christakis, D. A. (2016). Increased screen time: Implications for early childhood development and behavior. Pediatric Clinics, 63(5), 827-839. doi:10.1016/j.pcl.2016.06.006
https://doi.org/10.1016/j.pcl.2016.06.00...
; Schmidt et al., 2009Schmidt, M., Rich, M., Rifas-Shiman, S.L., Oken, E., & Taveras, E. M. (2009). Television viewing in infancy and child cognition at 3 years of age in a US cohort. Pediatrics,123(3), e370-e375.doi:10.1542/peds.2008-3221
https://doi.org/10.1542/peds.2008-3221...
; Strasburger, 2007Strasburger, V. (2007). First do no harm: Why have parents and pediatricians missed the boat on children and media? Journal of Pediatrics, 151(4), 334-336. doi:10.1016/j.jpeds.2007.05.040
https://doi.org/10.1016/j.jpeds.2007.05....
) or educational advantages of these technologies. Infants aged 30 months or younger can only learn from digital media through interactions with people around them (Radesky & Christakis, 2016Radesky, J. S., & Christakis, D. A. (2016). Increased screen time: Implications for early childhood development and behavior. Pediatric Clinics, 63(5), 827-839. doi:10.1016/j.pcl.2016.06.006
https://doi.org/10.1016/j.pcl.2016.06.00...
). Many of the apps downloaded by parents also have questionable educational potential and may not be adequate for their children’s age (Nevski & Siibak, 2016Nevski, E., & Siibak, A. (2016). The role of parents and parental mediation on 0-3-year olds’ digital play with smart devices: Estonian parents’ attitudes and practices. Early Years: International Research Journal, 36(3), 227-241. doi:10.1080/09575146.2016.1161601
https://doi.org/10.1080/09575146.2016.11...
). In conclusion, digital media cannot play an educational or formative role without the participation and interaction of a caregiver who mediates the technological experience (AAP & CCM, 2016; RCPCH, 2019).

Media use during meals, largely reported in our sample, may have a negative impact on family interactions, or encourage bad behavior (Radesky et al., 2015Radesky, J. S., Miller, A. L., Rosenblum, K. L., Appugliese, D., Kaciroti, N., & Lumeng, J. C. (2015). Maternal mobile device use during a structured parent-child interaction task. Academic Pediatrics, 15(2), 238-244. doi:10.1016/j.acap.2014.10.001
https://doi.org/10.1016/j.acap.2014.10.0...
). This behavior can also interfere with children’s food experience, leading to decreased interest in food, loss of appetite, or weight gain (SBP, 2019; WHO, 2019).

Despite only a few mothers having reported giving mobile devices to their children at bedtime, this finding contrasts with studies in which this behavior has been reported with higher frequency (Common Sense Media, 2017Common Sense Media. (2017). The Common Sense Census: Media use by kids age zero to eight. A special population: children under two. Retrieved from https://www.commonsense.org/zero-to-eight-census
https://www.commonsense.org/zero-to-eigh...
; Kabali et al., 2015Kabali, H. K., Irigoyen, M. M., Nunez-Davis, R., Budacki, J. G., Mohanty, S. H., Leister, K. P., & Bonner, R. L. (2015). Exposure and use of mobile media devices by young children. Pediatrics,136(6), 1044-50. doi:10.1542/peds.2015-2151
https://doi.org/10.1542/peds.2015-2151...
). The impact of media use on sleep has been associated with insufficient and poor-quality sleep and excessive day time sleepiness (Carter, Rees, Hale, Bhattacharjee, & Paradkar, 2016Carter, B., Rees, P., Hale, L., Bhattacharjee, D., & Paradkar, M. S. (2016). Association between portable screen-based media device access or use and sleep outcomes: A systematic review and meta-analysis. JAMA Pediatrics, 170(12), 1202-1208. doi:10.1001/jamapediatrics.2016.2341
https://doi.org/10.1001/jamapediatrics.2...
).

The use of digital media to calm children and to keep them from disturbing those around them-reported by mothers who took part in this study- was noted also by Kabali et al. (2015Kabali, H. K., Irigoyen, M. M., Nunez-Davis, R., Budacki, J. G., Mohanty, S. H., Leister, K. P., & Bonner, R. L. (2015). Exposure and use of mobile media devices by young children. Pediatrics,136(6), 1044-50. doi:10.1542/peds.2015-2151
https://doi.org/10.1542/peds.2015-2151...
), who found that 60% of families with infants use mobile phones to calm their child in public places. At this age, infants display significant changes in their behavior, which can take the form of temper tantrums when their wishes are not met. This is a normal stage of development known as the “terrible twos,” which mark the beginning of the infant’s struggle for independence and parents may see them reacting aggressively in response to frustration or challenges to their wishes (American Academy of Pediatrics [AAP], 2008American Academy of Pediatrics. (2008). Temper tantrums: A normal part of growing up. Retrieved from http://www.heardalliance.org/wp-content/uploads/2011/04/Parenting-Temper-Tantrums.pdf
http://www.heardalliance.org/wp-content/...
). In these situations, parents may offer their children digital devices to calm them down or stop a tantrum. Children with socioemotional difficulties are more likely to be given mobile phones to help them remain quiet and calm (Radesky et al., 2016Radesky, J. S., Peacock-Chambers, E., Zuckerman, B., & Silverstein, M. (2016). Use of mobile technology to calm upset children. JAMA Pediatrics, 170(4), 397-399. doi:10.1001/jamapediatrics.2015.4260
https://doi.org/10.1001/jamapediatrics.2...
). Infants and toddlers with self-regulation issues, in which children have difficulties calming down, may be associated to more frequent exposure to screen media by their caretakers (Radesky et al., 2014Radesky, J. S., Silverstein, M., Zuckerman, B., & Christakis, D. A. (2014). Infant self-regulation and early childhood media exposure. Pediatrics, 133(5), e1172-e1178.doi:10.1542/peds.2013-2367
https://doi.org/10.1542/peds.2013-2367...
). It is known that infants’ ability to regulate their emotions and behavior develop gradually with caregivers’ interactions, through a mutually regulated dyadic communication system (Chiodelli, Rodrigues, Pereira, Lopes dos Santos, & Fuertes, 2021Chiodelli, T., Rodrigues, O. M. P. R., Pereira, V. A., Lopes dos Santos, P., & Fuertes, M. (2021). Face-to-face still-face: Comparison between interactive behaviors of full-term and preterm infants. Paidéia (Ribeirão Preto),31, e3102.doi:10.1590/1982-4327e3102
https://doi.org/10.1590/1982-4327e3102...
). So it is difficult to determine whether media exposure was simply a parental strategy to manage children with pre-existing self-regulation issues or if the latter arose as a consequence of the media exposure itself.

Mothers in our study seem to have difficulties entertaining infants, as evidenced by the high number of respondents who use digital media with their children for entertainment purposes. Previous studies have shown that media use can interfere with playtime and emphasized the importance of children playing and interacting with others without the use of screens (McDaniel & Coyne, 2016McDaniel, B. T., & Coyne, S. M. (2016). Technology interference of in the parenting of young children: Implications for mothers’ perceptions of coparenting. The Social Science Journal, 53(4), 435-443. doi:10.1016/j.sos cij.2016.04.010
https://doi.org/10.1016/j.sos cij.2016.0...
; RCPCH, 2019). Playtime is an important moment for parents to establish emotional connection with their children, to stimulate their cognitive, physical,and social development, and also for the infant’s brain development (Shonkoff, 2017Shonkoff, J. P. (2017). Breakthrough impacts: What science tells us about supporting early childhood development. YC Young Children,72(2), 8-16. Retrieved from https://www.jstor.org/stable/90004117
https://www.jstor.org/stable/90004117...
). It is possible that mothers in our study do not know how to engage in unstructured play, resorting to technology as a means of interacting with their children. This is especially evident in the younger infants of our sample who require parental stimulation during play activities. The fact that parents use digital media to play and interact with their infants is, therefore, concerning.

Digital media is increasingly ubiquitous and, as a result, is often used by mothers. This may prompt a reaction from children that may initially appear to express their own need to access these devices but is actually an attempt to approach and interact with the mother. This hypothesis is supported by the literature since many studies show that infants compete for the attention of their parents when the latter are engrossed by digital media (Kildare & Middlemiss, 2017Kildare, C. A., & Middlemiss, W. (2017). Impact of parents mobile device use on parent-child interaction: A literature review. Computers in Human Behavior, 75, 579-593. doi:10.1016/j.chb.2017.06.003
https://doi.org/10.1016/j.chb.2017.06.00...
; Radesky et al., 2014Radesky, J. S., Silverstein, M., Zuckerman, B., & Christakis, D. A. (2014). Infant self-regulation and early childhood media exposure. Pediatrics, 133(5), e1172-e1178.doi:10.1542/peds.2013-2367
https://doi.org/10.1542/peds.2013-2367...
, 2016Radesky, J. S., Peacock-Chambers, E., Zuckerman, B., & Silverstein, M. (2016). Use of mobile technology to calm upset children. JAMA Pediatrics, 170(4), 397-399. doi:10.1001/jamapediatrics.2015.4260
https://doi.org/10.1001/jamapediatrics.2...
). Radesky et al. (2016Radesky, J. S., Peacock-Chambers, E., Zuckerman, B., & Silverstein, M. (2016). Use of mobile technology to calm upset children. JAMA Pediatrics, 170(4), 397-399. doi:10.1001/jamapediatrics.2015.4260
https://doi.org/10.1001/jamapediatrics.2...
) noticed that children were calmer and more relaxed when parents interacted with them in the absence of a telephone and that parents felt more present and connected to their children when digital media devices were put away. In this context, parents were more attentive, involved, and affectionatein their interactions. A similar observation was made in our study, where many participants felt that devices such as smartphones and tablets interfered with family habits, reducing the time they spent together.

The presence of affectionate and accessible caregivers is an important contributor to physical and emotional development. As such, excessive use or exposure to digital media should be minimized in favor of face-to-face interactions between parents and infants (RCPCH, 2019). It is important to ensure that interactions between parents and infants are not replaced or excessively mediated by digital media. This is especially relevant given recent findings on the impact of digital media use on parent-child relationships (Kildare & Middlemiss, 2017Kildare, C. A., & Middlemiss, W. (2017). Impact of parents mobile device use on parent-child interaction: A literature review. Computers in Human Behavior, 75, 579-593. doi:10.1016/j.chb.2017.06.003
https://doi.org/10.1016/j.chb.2017.06.00...
; McDaniel & Radesky, 2017McDaniel, B. T., & Radesky, J. S. (2017). Technoference: Parent distraction with technology and associations with child behavior problems.Child Development,89(1), 100-109. doi:10.1111/cdev.12822
https://doi.org/10.1111/cdev.12822...
; Munzer et al., 2019Munzer, T.G., Miller, A.L., Weeks, H.M., Kaciroti, N., & Radesky, J. (2019). Parent-toddler social reciprocity during reading from electronic tablets vs print books. JAMAPediatrics,173(11), 1076-1083. doi:10.1001/jamapediatrics.2019.3480
https://doi.org/10.1001/jamapediatrics.2...
; Radesky et al., 2015Radesky, J. S., Miller, A. L., Rosenblum, K. L., Appugliese, D., Kaciroti, N., & Lumeng, J. C. (2015). Maternal mobile device use during a structured parent-child interaction task. Academic Pediatrics, 15(2), 238-244. doi:10.1016/j.acap.2014.10.001
https://doi.org/10.1016/j.acap.2014.10.0...
).

The shared use of digital media between parents and children,with adults interacting and discussing its contents -as it was reported by a few mothers in our study- is considered an adequate use of digital media. In contrast, merely the use of digital media by children in the presence of an adult, commonly informed by many mothers in our sample - especially those with older children - does not indicate any involvement or interaction and is limited to distant supervision. The parent and infant could also be using the same device without talking about its contents, which would constitute a low-quality interaction (Munzer et al., 2019Munzer, T.G., Miller, A.L., Weeks, H.M., Kaciroti, N., & Radesky, J. (2019). Parent-toddler social reciprocity during reading from electronic tablets vs print books. JAMAPediatrics,173(11), 1076-1083. doi:10.1001/jamapediatrics.2019.3480
https://doi.org/10.1001/jamapediatrics.2...
) and is considered a harmful use of technology that could interfere with family relationships (McDaniel & Coyne, 2016McDaniel, B. T., & Coyne, S. M. (2016). Technology interference of in the parenting of young children: Implications for mothers’ perceptions of coparenting. The Social Science Journal, 53(4), 435-443. doi:10.1016/j.sos cij.2016.04.010
https://doi.org/10.1016/j.sos cij.2016.0...
; McDaniel & Radesky, 2017McDaniel, B. T., & Radesky, J. S. (2017). Technoference: Parent distraction with technology and associations with child behavior problems.Child Development,89(1), 100-109. doi:10.1111/cdev.12822
https://doi.org/10.1111/cdev.12822...
). In the absence of eye contact between infant and caregiver, there is probably less interaction or emotional connection (Winnicott, 1986/2005Winnicott, D. W. (2005). Tudo começa em casa [Home iswherewe start from](P. C. Sandler, Trans., 4th ed.). São Paulo, SP: Martins Fontes. (Original work published in 1986).), becoming a poor use of technology.

We observed that the frequency in which media is independently used increases with age,which is in line with findings reported in the literature (Rideout & Robb, 2020Rideout, V., & Robb, M. B. (2020). The Common Sense census: Media use by kids age zero to eight, 2020. Retrieved from https://www.commonsensemedia.org/sites/default/files/uploads/research/2020_zero_to_eight_census_final_web.pdf
https://www.commonsensemedia.org/sites/d...
).As previously discussed,parents often use digital media as a way to entertain infants while they carry out necessary activities, and this can result in solitary media use. In these conditions, digital media may be acting as a substitute for interpersonal play and interactions and leading to long periods of screen time with no interactions (Fidler, Zack & Barr, 2010Fidler, A. E., Zack, E., & Barr, R. (2010). Television viewing patterns in 6-to-18-month-olds: The role of caregiver-infant interactional quality. Infancy, 15(2), 176-196. doi:10.1111/j.1532-7078.2009.00013.x
https://doi.org/10.1111/j.1532-7078.2009...
) or conversations with individuals who could give meaning to this experience. Infancy is a period of physical and psychological immaturity that results in profound dependency (Winnicott, 1986/2005Winnicott, D. W. (2005). Tudo começa em casa [Home iswherewe start from](P. C. Sandler, Trans., 4th ed.). São Paulo, SP: Martins Fontes. (Original work published in 1986).). Individuals at this stage of development need help making sense of the information and virtual connections provided by digital media.

This study shows that mothers often use digital media as a way to entertain infants while they carry out necessary tasks. Previous studies (Kabali et al., 2015Kabali, H. K., Irigoyen, M. M., Nunez-Davis, R., Budacki, J. G., Mohanty, S. H., Leister, K. P., & Bonner, R. L. (2015). Exposure and use of mobile media devices by young children. Pediatrics,136(6), 1044-50. doi:10.1542/peds.2015-2151
https://doi.org/10.1542/peds.2015-2151...
; Mallmann & Frizzo, 2019Mallmann, M. Y., & Frizzo, G. B. (2019). O uso das novas tecnologias em famílias com bebês: Um mal necessário? [The use of new technologies in families with babies: A necessaryevil?]. Revista Cocar,(7), 26-46. doi:10.31792/rc.v0i7
https://doi.org/10.31792/rc.v0i7...
) found that the use of digital devices by infants was spurred by maternal necessity. However, it appears that infants may feel no need to use digital media, as they can distract themselves with other activities and toys rather than these devices and that they are given access to digital media to address mothers’ needs, not theirs (Mallmann & Frizzo, 2019Mallmann, M. Y., & Frizzo, G. B. (2019). O uso das novas tecnologias em famílias com bebês: Um mal necessário? [The use of new technologies in families with babies: A necessaryevil?]. Revista Cocar,(7), 26-46. doi:10.31792/rc.v0i7
https://doi.org/10.31792/rc.v0i7...
). Although it may be challenging to refrain from using digital media, it is important to identify these situations to help mothers find an alternative rather than resort to digital media as the first or only option. Above all, it is essential to ensure that in-person interactions within families are not disrupted or excessively mediated by technological resources.

One limitation of our study is the high socioeconomic and educational status of the sample - which can be the disadvantage of convenience samples on online surveys (Lourenco & Tasimi, 2020Lourenco, S. F., & Tasimi, A. (2020). No participant left behind: Conducting science during COVID-19. Trends in Cognitive Sciences, 24(8), 583-584. doi:10.1016/j.tics.2020.05.003
https://doi.org/10.1016/j.tics.2020.05.0...
). Further studies should investigate these issues in samples with different socioeconomic backgrounds. Another limitation of this study is that mothers may have had difficulty providing accurate reports of their children’s media use since children often use such devices in an autonomous and self-directed manner. An additional limitation is that data regarding the total duration of media use by mothers and infants were not collected. Accurate digital media usage time measurement is still a great challenge for researchers (Barr et al., 2020Barr, R., Kirkorian, H., Radesky, J., Coyne, S., Nichols, D., Blanchfield, O., … Fitzpatrick, C. (2020). Beyond screen time: A synergistic approach to a more comprehensive assessment of family media exposure during early childhood. Frontiers in Psychology,11, 1283. doi:10.3389/fpsyg.2020.01283
https://doi.org/10.3389/fpsyg.2020.01283...
). Finally, another limitation is that the type of digital media most frequently used by children and the nature of the contents to which they are exposed were not investigated. Future studies should examine these aspects and also the on-set of digital media usage.

This study’s major strength is its focus on a current and culturally relevant phenomenon, present in the daily lives of most families but still largely unexplored in literature. Our findings make a novel contribution to the literature since few studies have focused on examining the patterns and effects of digital media use in mothers with infants of different ages. This study adds to the current understanding of digital media use in infants and addresses many of its repercussions on child development, routine activities, and family interactions, with potentially wide-ranging public health implications.

References

  • Aguilar-Farias, N., Toledo-Vargas, M., Miranda-Marquez, S., Cortinez-O’Ryan, A., Cristi-Montero, C., Rodriguez-Rodriguez, F., ... Del Pozo Cruz, B. (2020). Sociodemographic predictors of changes in physical activity, screen time, and sleep among toddlers and preschoolers in Chile during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 18(1), 176. doi:10.3390/ijerph18010176
    » https://doi.org/10.3390/ijerph18010176
  • American Academy of Pediatrics. (2008). Temper tantrums: A normal part of growing up. Retrieved from http://www.heardalliance.org/wp-content/uploads/2011/04/Parenting-Temper-Tantrums.pdf
    » http://www.heardalliance.org/wp-content/uploads/2011/04/Parenting-Temper-Tantrums.pdf
  • American Academy of Pediatrics, & Council on Communications and Media. (2016). Media and young minds. Pediatrics, 138(5), e20162591. doi:10.1542/peds.2016-2591
    » https://doi.org/10.1542/peds.2016-2591
  • Arufe-Giráldez, V. I., Sanmiguel-Rodríguez, A., Zagalaz-Sánchez, M. L., Cachón-Zagalaz, J., & González-Valero, G. (2020). Sleep, physical activity and screens in 0-4 years Spanish children during the COVID-19 pandemic: Were the WHO recommendations met? Journal of Human Sport and Exercise, 17(3), 1-20. doi:10.14198/jhse.2022.173.02
    » https://doi.org/10.14198/jhse.2022.173.02
  • Barr, R., Kirkorian, H., Radesky, J., Coyne, S., Nichols, D., Blanchfield, O., … Fitzpatrick, C. (2020). Beyond screen time: A synergistic approach to a more comprehensive assessment of family media exposure during early childhood. Frontiers in Psychology,11, 1283. doi:10.3389/fpsyg.2020.01283
    » https://doi.org/10.3389/fpsyg.2020.01283
  • Cartanyà-Hueso, A., Lidón-Moyano, C., Cassanello, P., Díez-Izquierdo, A., Martín-Sánchez, J. C., Balaguer, A., & Martínez-Sánchez, J. M. (2021). Smartphone and tablet usage during COVID-19 pandemic confinement in children under 48 months in Barcelona (Spain). Healthcare (Basel, Switzerland), 9(1), 96. doi:10.3390/healthcare9010096
    » https://doi.org/10.3390/healthcare9010096
  • Carter, B., Rees, P., Hale, L., Bhattacharjee, D., & Paradkar, M. S. (2016). Association between portable screen-based media device access or use and sleep outcomes: A systematic review and meta-analysis. JAMA Pediatrics, 170(12), 1202-1208. doi:10.1001/jamapediatrics.2016.2341
    » https://doi.org/10.1001/jamapediatrics.2016.2341
  • Chiodelli, T., Rodrigues, O. M. P. R., Pereira, V. A., Lopes dos Santos, P., & Fuertes, M. (2021). Face-to-face still-face: Comparison between interactive behaviors of full-term and preterm infants. Paidéia (Ribeirão Preto),31, e3102.doi:10.1590/1982-4327e3102
    » https://doi.org/10.1590/1982-4327e3102
  • Common Sense Media. (2017). The Common Sense Census: Media use by kids age zero to eight. A special population: children under two. Retrieved from https://www.commonsense.org/zero-to-eight-census
    » https://www.commonsense.org/zero-to-eight-census
  • Common Sense Media. (2013). Zero to Eight: Children’s media use in America 2013. Retrieved from https://www.commonsensemedia.org/file/zero-to-eight-2013pdf-0/download
    » https://www.commonsensemedia.org/file/zero-to-eight-2013pdf-0/download
  • Duch, H., Fisher, E. M., Ensari, I., Font, M., Harrington, A., Taromino, C., … Rodriguez, C. (2013). Association of screen time use and language development in Hispanic toddlers: A cross-sectional and longitudinal study. Clinical Pediatrics, 52(9), 857-865. doi:10.1177/0009922813492881
    » https://doi.org/10.1177/0009922813492881
  • Elias, N., & Sulkin, I. (2017). YouTube viewers in diapers: An exploration of factors associated with amount of toddlers’ online viewing. Cyberpsychology: Journal of Psychosocial Research on Cyberspace, 11(3), 1-18. doi:10.5817/CP2017-3-2
    » https://doi.org/10.5817/CP2017-3-2
  • Fidler, A. E., Zack, E., & Barr, R. (2010). Television viewing patterns in 6-to-18-month-olds: The role of caregiver-infant interactional quality. Infancy, 15(2), 176-196. doi:10.1111/j.1532-7078.2009.00013.x
    » https://doi.org/10.1111/j.1532-7078.2009.00013.x
  • Kabali, H. K., Irigoyen, M. M., Nunez-Davis, R., Budacki, J. G., Mohanty, S. H., Leister, K. P., & Bonner, R. L. (2015). Exposure and use of mobile media devices by young children. Pediatrics,136(6), 1044-50. doi:10.1542/peds.2015-2151
    » https://doi.org/10.1542/peds.2015-2151
  • Kildare, C. A., & Middlemiss, W. (2017). Impact of parents mobile device use on parent-child interaction: A literature review. Computers in Human Behavior, 75, 579-593. doi:10.1016/j.chb.2017.06.003
    » https://doi.org/10.1016/j.chb.2017.06.003
  • Lourenco, S. F., & Tasimi, A. (2020). No participant left behind: Conducting science during COVID-19. Trends in Cognitive Sciences, 24(8), 583-584. doi:10.1016/j.tics.2020.05.003
    » https://doi.org/10.1016/j.tics.2020.05.003
  • Mallmann, M. Y., & Frizzo, G. B. (2019). O uso das novas tecnologias em famílias com bebês: Um mal necessário? [The use of new technologies in families with babies: A necessaryevil?]. Revista Cocar,(7), 26-46. doi:10.31792/rc.v0i7
    » https://doi.org/10.31792/rc.v0i7
  • McDaniel, B. T., & Coyne, S. M. (2016). Technology interference of in the parenting of young children: Implications for mothers’ perceptions of coparenting. The Social Science Journal, 53(4), 435-443. doi:10.1016/j.sos cij.2016.04.010
    » https://doi.org/10.1016/j.sos cij.2016.04.010
  • McDaniel, B. T., & Radesky, J. S. (2017). Technoference: Parent distraction with technology and associations with child behavior problems.Child Development,89(1), 100-109. doi:10.1111/cdev.12822
    » https://doi.org/10.1111/cdev.12822
  • Munzer, T.G., Miller, A.L., Weeks, H.M., Kaciroti, N., & Radesky, J. (2019). Parent-toddler social reciprocity during reading from electronic tablets vs print books. JAMAPediatrics,173(11), 1076-1083. doi:10.1001/jamapediatrics.2019.3480
    » https://doi.org/10.1001/jamapediatrics.2019.3480
  • Napier, C. (2014). How use of screen media affects the emotional development of infants. Primary Health Care, 24(2), 18-25. doi:10.7748/phc2014.02.24.2.18.e816
    » https://doi.org/10.7748/phc2014.02.24.2.18.e816
  • Nevski, E., & Siibak, A. (2016). The role of parents and parental mediation on 0-3-year olds’ digital play with smart devices: Estonian parents’ attitudes and practices. Early Years: International Research Journal, 36(3), 227-241. doi:10.1080/09575146.2016.1161601
    » https://doi.org/10.1080/09575146.2016.1161601
  • Núcleo de Pesquisa e Intervenção em Famílias com Bebês e Crianças. (2017). Questionário de dados sócio-demográficos [Socio-demographic data questionnaire].Porto Alegre, RS: Universidade Federal do Rio Grande do Sul. Instrumento não publicado.
  • Piaget, J. (1978). O nascimento da inteligência na criança [The origins of intelligence in children](A. Cabral, Trans., 3rd ed.). Rio de Janeiro, RJ: Zahar. (Original work published 1936).
  • Radesky, J. S., & Christakis, D. A. (2016). Increased screen time: Implications for early childhood development and behavior. Pediatric Clinics, 63(5), 827-839. doi:10.1016/j.pcl.2016.06.006
    » https://doi.org/10.1016/j.pcl.2016.06.006
  • Radesky, J. S., Miller, A. L., Rosenblum, K. L., Appugliese, D., Kaciroti, N., & Lumeng, J. C. (2015). Maternal mobile device use during a structured parent-child interaction task. Academic Pediatrics, 15(2), 238-244. doi:10.1016/j.acap.2014.10.001
    » https://doi.org/10.1016/j.acap.2014.10.001
  • Radesky, J. S., Peacock-Chambers, E., Zuckerman, B., & Silverstein, M. (2016). Use of mobile technology to calm upset children. JAMA Pediatrics, 170(4), 397-399. doi:10.1001/jamapediatrics.2015.4260
    » https://doi.org/10.1001/jamapediatrics.2015.4260
  • Radesky, J. S., Silverstein, M., Zuckerman, B., & Christakis, D. A. (2014). Infant self-regulation and early childhood media exposure. Pediatrics, 133(5), e1172-e1178.doi:10.1542/peds.2013-2367
    » https://doi.org/10.1542/peds.2013-2367
  • Raman, S., Guerrero-Duby, S., McCullough, J. L., Brown, M., Ostrowski-Delahanty, S., Langkamp, D., & Duby, J. C. (2017). Screen exposure during daily routinesand a young child’s risk for having social-emotional delay. ClinicalPediatrics, 56(13), 1244-1253. doi:10.1177/0009922816684600
    » https://doi.org/10.1177/0009922816684600
  • Rideout, V., & Robb, M. B. (2020). The Common Sense census: Media use by kids age zero to eight, 2020. Retrieved from https://www.commonsensemedia.org/sites/default/files/uploads/research/2020_zero_to_eight_census_final_web.pdf
    » https://www.commonsensemedia.org/sites/default/files/uploads/research/2020_zero_to_eight_census_final_web.pdf
  • Robson, C. (2002). Real-world research: A resource for social scientists and practitioner-researchers (2nd ed.). Malden, MA: Blackwell.
  • Royal College of Paediatrics and Child Health. (2019). The health impacts of screen time: A guide for clinicians and parents. Retrieved from https://www.rcpch.ac.uk/resources/health-impacts-screen-time-guide-clinicians-parents
    » https://www.rcpch.ac.uk/resources/health-impacts-screen-time-guide-clinicians-parents
  • Schmidt, M., Rich, M., Rifas-Shiman, S.L., Oken, E., & Taveras, E. M. (2009). Television viewing in infancy and child cognition at 3 years of age in a US cohort. Pediatrics,123(3), e370-e375.doi:10.1542/peds.2008-3221
    » https://doi.org/10.1542/peds.2008-3221
  • Shonkoff, J. P. (2017). Breakthrough impacts: What science tells us about supporting early childhood development. YC Young Children,72(2), 8-16. Retrieved from https://www.jstor.org/stable/90004117
    » https://www.jstor.org/stable/90004117
  • Sociedade Brasileira de Pediatria. (2019). #Menostela #maissaúde: Manual de orientação [#Less screen #more health: Guidance manual]. Retrieved from https://www.sbp.com.br/imprensa/detalhe/nid/menos-telas-mais-saude/
    » https://www.sbp.com.br/imprensa/detalhe/nid/menos-telas-mais-saude/
  • Strasburger, V. (2007). First do no harm: Why have parents and pediatricians missed the boat on children and media? Journal of Pediatrics, 151(4), 334-336. doi:10.1016/j.jpeds.2007.05.040
    » https://doi.org/10.1016/j.jpeds.2007.05.040
  • Winnicott, D. W. (2005). Tudo começa em casa [Home iswherewe start from](P. C. Sandler, Trans., 4th ed.). São Paulo, SP: Martins Fontes. (Original work published in 1986).
  • World Health Organization. (‎2019). Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. Geneva, Switzerland: Author.Retrieved from http://www.who.int/iris/handle/10665/311664
    » http://www.who.int/iris/handle/10665/311664

  • This article is derived from the first author’s dissertation under supervision of the fourth, defended in 2020, in the Graduate Program in Psychology of the Universidade Federal do Rio Grande do Sul. Funding Support: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) 88882.346437/2019-01, Financing Code: 001 (from the first author) and Programa Nacional de Pós-Doutorado (PNPD) (from the third author).

Publication Dates

  • Publication in this collection
    15 Apr 2022
  • Date of issue
    2022

History

  • Received
    26 Aug 2021
  • Reviewed
    21 Oct 2021
  • Accepted
    07 Dec 2021
Universidade de São Paulo, Faculdade de Filosofia Ciências e Letras de Ribeirão Preto, Programa de Pós-Graduação em Psicologia Av.Bandeirantes 3900 - Monte Alegre, 14040-901 Ribeirão Preto - São Paulo - Brasil, Tel.: (55 16) 3315-3829 - Ribeirão Preto - SP - Brazil
E-mail: paideia@usp.br